延续护理对冠心病PCI术后康复患者的影响

Influence of continuation care on rehabilitation of patients with coronary heart disease after PCI

目的探讨延续护理对冠心病经皮冠状动脉介入(PCI)术后康复患者的影响。方法选取湖北医药学院附属太和医院2010年7月至2015年6月收治且行PCI治疗的冠心病患者3 000例,采用简单随机抽签法分为延续护理组与传统护理组,每组各1 500例。延续护理组实施延续护理干预,而传统护理组则给予传统护理干预;比较两组患者一年时的自我管理水平、焦虑心理、危险因素以及心血管事件发生率等指标的差异。结果 1延续护理组自我管理总评分为(86.78±8.12)分,明显高于传统护理组的(78.28±7.58)分,SAI评分下降为(39.42±3.79)分,明显低于传统护理组的(49.86±4.22)分,差异均有显著统计学意义(P<0.01);2延续护理组的吸烟、高血压病、糖尿病、高低密度脂蛋白-胆固醇(LDL-C)以及低高密度脂蛋白胆固醇(HDL-C)的患者分别为162例(10.80%)、135例(9.00%)、228例(15.20%)、564例(37.60%)、342例(22.80%),均少于或低于传统护理组的612例(40.80%)、564例(37.60%)、462例(30.80%)、993例(66.20%)、846例(56.40%),差异均有显著统计学意义(P<0.01);3延续护理组的心绞痛、心肌梗死、再次血运重建以及心源性休克/死亡的发生率分别为2.93%、1.53%、1.87%、0.53%,均少于或低于传统护理组12.20%、10.20%、11.07%、1.40%,差异均有统计学意义(P<0.01或<0.05)。结论延续护理可以明显改善PCI术后患者自我管理行为、焦虑心理,降低危险因素和心血管事件的发生率。

Objective To discuss the effect of continuation care(CC) on rehabilitation of patients with coronary heart disease(CHD) after percutaneous coronary intervention(PCI).Methods A total of 3 000 patients with coronary heart disease who underwent PCI in Taihe Hospital Affiliated to Hubei Medical College from July 2010 to June2015 were selected.The simple random method was used to divide the patients into the CC group and the traditional nursing(TN) group,with 1 500 patients in each group.CC group was implemented continuation care intervention,and the TN group was given traditional nursing intervention.The difference of self management,anxiety,risk factors and incidence of cardiovascular events were compared between the two groups of patients for a year.Results 1 The total score of self management was(86.78 ± 8.12) in CC group,which was significantly higher than that in TN group of(78.28 ± 7.58),and the score of SAI decreased to(39.42±3.79),which was significantly lower than that in TN group of(49.86±4.22),with statistically significant difference(P<0.01);2 The smoking,hypertension,diabetes,high and low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),hyperlipidemia(TG),and low high density lipoprotein cholesterol(HDL-C) of CC group were respectively 162 cases(10.80%),135 cases(9.00%),228(15.20%),564 cases(37.6%) and 342 cases(22.80%),which were significantly less than or less than those of TN group 612 cases(40.80%),564 cases(37.60%),462 cases(30.80%),993 cases(66.20%),846 cases(56.40%),with statistically significant difference(P<0.01);3 The incidence of angina pectoris,myocardial infarction,revascularization and cardiac shock/death of CC group were respectively 2.93%,1.53%,1.87%,0.53%,which were significantly less than or less than those of TN group12.20%,10.20%,11.07%,1.40%,with statistically significant difference(P<0.01 or P<0.05).Conclusion Continuation care can obviously improve the self-management behavior and state anxiety in patients with PCI postoperative,which reduce the incidence of risk factors and cardiovascular events.